title: The validity and utility of the M. D. Anderson Symptom Inventory in patients with breast cancer: evidence from the symptom outcomes and practice patterns data from the eastern cooperative oncology group.
abstract: BACKGROUND
  The M. D. Anderson Symptom Inventory (MDASI) is a psychometrically validated patient-reported outcome measurement that assesses the severity and impact of multiple symptoms related to cancer and its treatment. With the MDASI, patients rate 13 common "core" symptoms and 6 items that reflect symptom interference with functioning. Several MDASI modules (core symptom and interference items plus additional symptoms specific to a particular cancer type or treatment modality) have been developed. Although the original MDASI validation study encompassed various cancer types, the instrument's psychometric properties have not been examined in a homogenous sample of patients with breast cancer in a national multicenter study.
  
  
  METHODS
  We performed a secondary analysis of data from an Eastern Cooperative Oncology Group study to establish the reliability, validity, and sensitivity of the MDASI in a large sample of patients with breast cancer (n = 1544), 78% of whom were receiving treatment. The instrument was administered twice, approximately 1 month apart.
  
  
  RESULTS
  Internal consistency and test-retest reliability were adequate, with Cronbach α values ≥ 0.85 and intraclass correlations ≥ 0.76 for all subscales. Known-group validity was evaluated by using performance status, tumor response, and disease stage. Sensitivity to change in patient-reported quality of life was established.
  
  
  CONCLUSIONS
  The MDASI is a valid, reliable, and sensitive symptom-assessment instrument that can enhance descriptive and clinical studies of symptom status in patients with breast cancer. Future studies might include cognitive debriefing and qualitative interviews to identify additional disease-specific items for inclusion in a MDASI breast cancer module.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: tmendoza@mdanderson.org.
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Fengmin
authors.initials: F
authors.lastname: Zhao
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.forename: Lynne I
authors.initials: LI
authors.lastname: Wagner
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Patrick-Miller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000453:epidemiology; D057189:Checklist; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011364:Professional Practice / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Eastern Cooperative Oncology Group; M. D. Anderson Symptom Inventory; Patient-reported outcome; Symptom assessment; Validation